心得安降低血吸虫病窦前性门静脉高压症的静脉压力和管壁张力。
Propranolol reduces variceal pressure and wall tension in schistosomiasis presinusoidal portal hypertension.
机构信息
Department of Gastroenterology, University of São Paulo School of Medicine, Brazil.
出版信息
J Gastroenterol Hepatol. 2009 Dec;24(12):1852-6. doi: 10.1111/j.1440-1746.2009.05912.x.
BACKGROUND AND AIM
Although prophylaxis with beta-blockers has been shown to decrease variceal pressure and wall tension in cirrhotic patients, this has not been demonstrated in non-cirrhotic portal hypertension caused by Schistosoma mansoni infection.
METHODS
Thirteen patients without history of previous gastrointestinal bleeding were included. All of them had high-risk esophageal varices at endoscopy. An endoscopic gauge and a high-frequency endoscopic ultrasonography miniprobe were used to assess transmural variceal pressure and wall tension before and after achieving beta-blockade with propranolol.
RESULTS
Baseline variceal pressure decreased from 13.3 +/- 3.5 to 8.2 +/- 2.0 mmHg (P < 0.0001) and wall tension from 500.2 +/- 279.8 to 274.0 +/- 108.3 mg.mm(-1). The overall effect of propranolol on decreasing variceal pressure and wall tension expressed in percentage change in relation to baseline values was 35.7 +/- 18.4% and 35.9 +/- 26.7%, respectively (P = 0.9993).
CONCLUSION
Propranolol significantly reduced variceal pressure and wall tension in schistosomiasis.
背景与目的
虽然β受体阻滞剂的预防治疗已被证实可降低肝硬化患者的静脉压力和壁张力，但在由曼氏血吸虫感染引起的非肝硬化性门静脉高压症中尚未得到证实。
方法
纳入了 13 例无既往胃肠道出血史的患者。所有患者在内镜下均存在高危食管静脉曲张。使用内镜测压器和高频内镜超声微型探头，在使用普萘洛尔实现β受体阻滞剂治疗前后，评估穿壁性静脉压力和壁张力。
结果
静脉压力从 13.3 ± 3.5mmHg 降至 8.2 ± 2.0mmHg（P < 0.0001），壁张力从 500.2 ± 279.8mg.mm(-1) 降至 274.0 ± 108.3mg.mm(-1)。普萘洛尔对降低静脉压力和壁张力的总体效果，以与基线值相比的百分比变化表示，分别为 35.7 ± 18.4%和 35.9 ± 26.7%（P = 0.9993）。
结论
普萘洛尔可显著降低血吸虫病患者的静脉压力和壁张力。
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